Self-managing HIV/AIDS: cultural competence and health among women in Nairobi, Kenya.

Despite recent efforts to supply antiretroviral therapy, many in Africa are not receiving medication, instead relying on self-management in their attempts to remain healthy. In Kenya, the majority of those infected are women who are below the extreme poverty level. Building on research demonstrating a link between knowledge of HIV/AIDS management and the length of time HIV-positive women have lived in Nairobi, this article uses a cognitive anthropological approach that conceives of culture as shared models and explores the relationship between how well women know a cultural model of self-managing HIV/AIDS and health among women who are not receiving biomedical treatment. Outcomes include reported perceived stress, depressive symptoms, and recent illness episodes. Here, this association of competence in the shared cultural model and health among women living in extremely marginal economic conditions is explored from a biocultural perspective to better understand this relationship. Knowledge of the model is a significant predictor of better overall health even after controlling for age, education, income, marital status, internal locus of control, and how long women have known that they are HIV-positive. This article adds to the HIV/AIDS literature by quantitatively linking health to cultural knowledge among an HIV-positive population. It also contributes to the cultural consensus literature by demonstrating health benefits of cultural knowledge.

To Keep this Disease from Killing You: Cultural Competence, Consonance, and Health among HIV-positive Women in Kenya.

The HIV/AIDS crisis continues in sub-Saharan Africa, where nearly 70% of infections are found. Despite recent efforts to supply antiretroviral therapy to those infected, most are not receiving medication and are forced to rely on self-management to remain healthy. In Kenya, many of those infected are women living in extreme poverty. This article presents the findings of research among poor women in Nairobi that examined the relationship between knowledge of a cultural model of self-managing HIV/AIDS, cultural consonance, and health. This biocultural study expands on earlier findings showing that knowledge of the model (competence) is a significant predictor of health by examining here how behavior consistent with that knowledge (consonance) affects health outcomes, as measured by CD4 counts, perceived stress, depressive symptoms, and recent illnesses.